The Pharmaceutical Journal Vol 264 No 7091 p542
April 8, 2000 Letters

Martindale

From take-over bid to hand-over

From Mr R. Blyth, FRPharmS

SIR,-The Royal Pharmaceutical Society's byelaws were changed in 1998 to provide for the appointment of a non-pharmacist Secretary and Registrar. At about the same time a new system of management of the Society was introduced; it includes a team of six directors, only two of whom are pharmacists. Now the next editor of Martindale may not be a pharmacist, but a clinical pharmacologist. Are pharmacists a threatened species at the Society? Is the Council anti-pharmacist?
As to the latest proposal regarding Martindale, has the controversy over clinical pharmacology 30 years ago been forgotten? The post is being advertised to a qualified (sic) pharmacist or clinical pharmacologist with excellent pharmaceutical knowledge (PJ, March 11, pA32).
As I see it, the Society's Council is offering the editorship of the flagship of the Society's book publishing activities to those who in the past have challenged the pharmacist's position in the dissemination of information about new drugs. The history of the matter is briefly as follows:
In 1967, the British Medical Journal suggested that the dissemination of information about new drugs - particularly knowledge about the interactions of new drugs and special contraindications - should be a matter for the clinical pharmacologist rather than for the "understaffed, overpressed hospital pharmacist".¹
In 1969, the Royal College of Physicians published a report which sponsored the creation of a "physician with a special interest in clinical pharmacology". He would work as a physician at a district hospital and, among other stated duties, "would play an important part in the dissemination of information about drugs to his colleagues and to general practitioners in his area, and an essential part of his duties would be the education of junior hospital staff". The Pharmaceutical Journal commented: "Such a development seems clearly to encroach upon the existing responsibilities of certainly the hospital pharmacist and, one would think, seems to be none too relevant to the real tasks of the clinical pharmacologist".²
Then, in 1970, a World Health Organisation report drew this comment from the PJ: "It is very strange that the group responsible for the report, while defining clinical pharmacology as being concerned with the scientific study of drugs, should manage to avoid almost totally specifically mentioning that pharmacy might have a part to play in this relatively new specialty. Indeed, the pharmacist's claim to be the expert on drugs and the adviser to the doctor in that sphere seems to have been completely overlooked. This, however, has not prevented the study group from suggesting the take-over by, presumably, non-pharmacist clinical pharmacologists of responsibility for advice on ‘the efficacy and safety of a drug, its indications and contraindications, dosage schedule, and interactions with other drugs', research on ‘the absorption, distribution, metabolism and excretion of drugs', design and execution of clinical trials, monitoring prescribing patterns, investigation of errors by patients in following directions for taking drugs and of dispensing errors by nurses and pharmacists, and planning the provision and dissemination of information about drug actions, interactions and toxicity. All this seems strangely at variance with pharmacy's own thoughts about its future and, for that matter, with certain of the current pharmaceutical educational trends. [The Society's Council of the day had, in 1967, set up a committee and subsequently a working party which led to increasing emphasis upon the teaching in schools of pharmacy of applied pharmacology.]
"The difficulty seems to be that in considering this new development the medical profession is drawing or attempting to draw within the orbit of clinical pharmacology too much of what is in fact pharmacy".³
I hope that, in the light of the above, members of the Society's Council will give serious thought to what is being contemplated.
Perhaps the Council should also give some consideration to the conseqences of the 1997 Banks report which, as may be seen from this latest dysfunctional decision, may have sown the seed of an evil weed with its proposal for a non-pharmacist Secretary and Registrar. The road to hell is paved with good intentions.
Perhaps the Council will renew its faith in our profession and put its trust in pharmacists rather than the potions of business consultants. They made the BBC somewhat sick.

Robert Blyth
Milton Keynes, Buckinghamshire

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